As medical cures advance, the umbrella covering chronic conditions does, too. Increasingly, the future of cancer treatment, with increased numbers of immunotherapies and oral oncolytics, will begin to emulate treatments for chronic illnesses. Along with this progress come big questions, like when, if ever will it be safe for a cancer patient to stop treatment?
There exists a massive difference for the continuum between paying $120,000 or more for 1 year of therapy with 6- to 12-month survival rates for cancer patients compared with the same $120,000 per year for an indefinite number of years as treatment efficacy grows.
Oral oncolytics are a more convenient option for patients who do not wish to travel to receive infusion treatments from their oncologist. In addition, this form of treatment fits much more easily into patients’ existing way of life.
Payment responsibilities for oral oncolytics will likely fall under medical insurance coverage, rather than pharmacy insurance, and will place a significant financial burden on payers and pharmacy benefit managers.
If cancer treatment trends toward that of HIV or hepatitis C, we will see a slew of combination therapies while the industry works steadily toward a 1-pill, once-a-day treatment. If adherence were to remain in the 20% to 50% realm, it would be disastrous for all concerned, and lead to significant increases in the existing $100 billion to $300 billion in wasted health care spending due to medication nonadherence.
Similar to the goals for other chronic conditions, improving outcomes, reducing cost and increasing adherence should be the targets for advanced oncology therapies.
Interested in learning how payers and manufacturers can obtain the greatest value for all stakeholders concerning cancer treatment? Read Marc’s full article at Specialty Pharmacy Times.
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